Innate Immune Cells and C-Reactive Protein in Acute First-Episode Psychosis and Schizophrenia: Relationship to Psychopathology and Treatment
| Autor: | Hans-Gert Bernstein, Peter Falkai, Johann Steiner, Bernhard Bogerts, Thomas Frodl, Paul C. Guest, Henrik Dobrowolny, Sabine Bahn, Brisa Simoes Fernandes, Kolja Schiltz, Gabriela Meyer-Lotz, Katrin Borucki, Roland Jacobs |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
drug therapy [Schizophrenia] pharmacology [Antipsychotic Agents] Leukocyte Count 0302 clinical medicine physiopathology [Psychotic Disorders] neutrophils drug effects [C-Reactive Protein] immunology [Psychotic Disorders] Leukocytes innate immunity biology Positive and Negative Syndrome Scale Middle Aged drug therapy [Psychotic Disorders] immunology [Schizophrenia] Psychiatry and Mental health medicine.anatomical_structure C-Reactive Protein Schizophrenia Female eosinophils monocytes Antipsychotic Agents Adult Psychosis drug effects [Immunity Innate] 03 medical and health sciences Young Adult Immune system monocyte-lymphocyte ratio (MLR) medicine Humans ddc:610 blood [Psychotic Disorders] Innate immune system business.industry neutrophil-lymphocyte ratio (NLR) Multiple sclerosis Monocyte drug effects [Leukocytes] C-reactive protein medicine.disease Immunity Innate 030227 psychiatry immunology [Immunity Innate] Psychotic Disorders blood [Schizophrenia] Immunology biology.protein physiopathology [Schizophrenia] business 030217 neurology & neurosurgery Regular Articles Follow-Up Studies |
| Zdroj: | Schizophrenia bulletin 46(2), 363-373 (2019). doi:10.1093/schbul/sbz068 Schizophrenia Bulletin |
| DOI: | 10.1093/schbul/sbz068 |
| Popis: | Innate immunity has been linked to initiation of Alzheimer’s disease and multiple sclerosis. Moreover, risk of first-episode psychosis (FEP) and schizophrenia (Sz) is increased after various infections in predisposed individuals. Thus, we hypothesized an analogous role of innate immunity with increased C-reactive protein (CRP) in non-affective psychosis. Differential blood count, CRP, neutrophil and monocyte–macrophage activation markers, cortisol and psychotic symptoms (Positive and Negative Syndrome Scale [PANSS]) were assessed in controls (n = 294) and acutely ill unmedicated FEP (n = 129) and Sz (n = 124) patients at baseline and after 6 weeks treatment. Neutrophils, monocytes, and CRP were increased in patients vs controls at baseline (P < .001), and neutrophil and monocyte counts correlated positively with activation markers. Eosinophils were lower at baseline in FEP (P < .001) and Sz (P = .021) vs controls. Differences in neutrophils (P = .023), eosinophils (P < .001), and CRP (P < .001) were also present when controlling for smoking and cortisol, and partially remitted after antipsychotic treatment. FEP patients with high neutrophils (P = .048) or monocytes (P = .021) had higher PANSS-P scores at baseline but similar disease course. CRP correlated with PANSS-P at baseline (ρ = 0.204, P = .012). Improvement of positive symptoms after treatment correlated with declining neutrophils (ρ = 0.186, P = .015) or CRP (ρ = 0.237, P = .002) and rising eosinophils (ρ = −0.161, P = .036). In FEP, normalization of neutrophils (ρ = −0.231, P = .029) and eosinophils (ρ = 0.209, P = .048) correlated with drug dosage. In conclusion, innate immune system activation correlated with PANSS-P, supporting the immune hypothesis of psychosis. Neutrophil and monocyte counts and CRP levels may be useful markers of disease acuity, severity, and treatment response. |
| Databáze: | OpenAIRE |
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